Breast Cancer Therapy Induced Right Ventricular Cardiomyopathy: A Single Institute Experience

Background It is well-known that chemotherapy medicines can cause cardiomyopathy and left ventricular dysfunction as adverse effects. There is scant evidence concerning the effects of chemotherapeutic drugs on the integrity & functionality of the right ventricle (RV). Aim To study the impact of cardiotoxic systemic therapy on right ventricular function in nonmetastatic breast cancer cases, particularly evaluating the efficacy of modern echocardiographic procedures for the early recognition of RV cardiomyopathy. Patient and Method A total of 104 women diagnosed with breast cancer participated in this prospective trial. Two therapy groups were established for the cases: 42 patients received anthracycline therapy, while 62 patients received a combination of anthracycline & trastuzumab. Results Patients treated with anthracycline and/or trastuzumab had more marked changes in RV function, RV FAC and pulmonary artery pressure, regardless of laterality. Right ventricular function was significantly impaired following anthracycline-based therapy, with more pronounced effects observed in cases receiving the combination of anthracycline and trastuzumab. The incidence of pulmonary hypertension increased significantly, with significant change in RVSP and TAPSE across the cohort. The study found that global RV strain was more negative during therapy (around -20.5% to - 20.9%) for both left- sided and right-sided groups. After therapy, global strain improved slightly, showing recovery. There was no significant difference in the global strain among the left- sided & right- sided groups post-therapy (around -22.8% to -23.4%). Conclusion Chemotherapy using anthracyclines and trastuzumab adversely impacts right ventricular function, resulting in a reduction of RVEF, RVFAC, RV Global Strain, and LVEF.